Non-convulsive status epilepticus in two patients with tuberous sclerosis

Tuberous sclerosis (TSC) is an autosomal dominantly inherited genetic disorder that chiefly affects the central nervous system, along with the other multiple systems. While phenomenology and symptom severity may vary greatly from one individual to another, the most common neurological presentation is epilepsy, which may be refractory in a considerable number of patients. Convulsive SE is seen frequently in TSC patients due to the high ratio of refractory seizures in well-studied cohorts. Status epilepticus (SE) is a life-threating condition and requires urgent medical care. Non-convulsive status epilepticus (NCSE) is an epileptic state with no convulsive seizures but impaired consciousness and corresponding electrophysiological findings. Due to its heterogeneity of clinical features, it is generally hard to recognize, and thus difficult to treat promptly. The relationship between TSC and NCSE is a relatively less emphasized issue in the literature. Here, we present two cases of TSC with NCSE with a view to increasing clinicians' awareness of the association between refractory epilepsy and NCSE

Acute-Onset Hemiparkinsonism Secondary to Subacute-Chronic Subdural Hematoma

Subdural hematomas constitute rare causes of secondary Parkinsonism in elderly. Subacute or chronic subdural hematomas occur in the elderly following minor head trauma or even without a remarkable history of trauma. A 69-year-old woman admitted with a rapidly progressive acute-onset hemiparkinsonism on the left side of her body. She denied any precipitating event before the onset of her symptoms, and her medical history was unremarkable. The anti-Parkinsonian therapy showed no benefit, but gradually worsening of the symptoms was observed. Her brain magnetic resonance imaging revealed a large subacute-chronic subdural hematoma on the right side with a mass effect on the basal ganglia structures, contralateral to her symptomatology. On thorough questioning, she confessed to having fallen out of the bed at night almost four weeks ago, three-weeks before the onset of her symptomatology. She had no complications associated with this fall and merely remembered this event. She denied any history of rapid eye movements (REM) sleep behavior disorder. The anti-Parkinsonian treatment was discontinued; the subdural hematoma was evacuated via burr hole drainage surgery. Her symptoms disappeared instantly after the surgery, with a normal neurologic examination one week after the surgery

RAB25 confers resistance to chemotherapy by altering mitochondrial apoptosis signaling in ovarian cancer cells

Ovarian cancer remains one of the most frequent causes of cancer-related death in women. Many patients with ovarian cancer suffer from de novo or acquired resistance to chemotherapy. Here, we report that RAB25 suppresses chemotherapy-induced mitochondrial apoptosis signaling in ovarian cancer cell lines and primary ovarian cancer cells. RAB25 blocks chemotherapy-induced apoptosis upstream of mitochondrial outer membrane permeabilization by either increasing antiapoptotic BCL-2 proteins or decreasing proapoptotic BCL-2 proteins. In particular, BAX expression negatively correlates with RAB25 expression in ovarian cancer cells. BH3 profiling assays corroborated that RAB25 decreases mitochondrial cell death priming. Suppressing RAB25 by means of RNAi or RFP14 inhibitory hydrocarbon-stapled peptide sensitizes ovarian cancer cells to chemotherapy as well as RAB25-mediated proliferation, invasion and migration. Our data suggest that RAB25 is a potential therapeutic target for ovarian cancer

Hand Pronation-Supination Movement as a Proxy for Remotely Monitoring Gait and Posture Stability in Parkinson's Disease

The Unified Parkinson's Disease Rating Scale (UPDRS) is a subjective Parkinson's Disease (PD) physician scoring/monitoring system. To date, there is no single upper limb wearable/non-contact system that can be used objectively to assess all UPDRS-III motor system subgroups (i.e., tremor (T), rigidity (R), bradykinesia (B), gait and posture (GP), and bulbar anomalies (BA)). We evaluated the use of a non-contact hand motion tracking system for potential extraction of GP information using forearm pronation-supination (P/S) motion parameters (speed, acceleration, and frequency). Twenty-four patients with idiopathic PD participated, and their UPDRS data were recorded bilaterally by physicians. Pearson's correlation, regression analyses, and Monte Carlo validation was conducted for all combinations of UPDRS subgroups versus motion parameters. In the 262,125 regression models that were trained and tested, the models within 1% of the lowest error showed that the frequency of P/S contributes to approximately one third of all models; while speed and acceleration also contribute significantly to the prediction of GP from the left-hand motion of right handed patients. In short, the P/S better indicated GP when performed with the non-dominant hand. There was also a significant negative correlation (with medium to large effect size, range: 0.3-0.58) between the P/S speed and the single BA score for both forearms and combined UPDRS score for the dominant hand. This study highlights the potential use of wearable or non-contact systems for forearm P/S to remotely monitor and predict the GP information in PD

<b>Unmasking spiritual void as a predictor of burnout:</b><b> </b><b>A study of health workers during the pandemic in Turkey</b>

Healthcare professionals are facing a crisis of burnout that is receiving increasing attention. The COVID-19 pandemic has intensified interest in this scenario. The aim of this study was to determine the prevalence of burnout among healthcare workers in a university hospital during the COVID-19 pandemic and to examine the potential impact of lack of spirituality on burnout. In this cross-sectional study, 546 employees were reached and a questionnaire, the Religious and Unspiritual Scale and the Copenhagen Burnout Scale were used to collect data. The study revealed that non-spirituality was a significant predictor of personal burnout (β=1.27; p=0.045). The findings suggest that lack of spirituality may be a potential pathway that complicates recovery for healthcare professionals struggling with burnout. This highlights the need for healthcare organizations to recognize the importance of spiritual health and incorporate it into their employee support programs.</p

Reliability and validity of the Turkish version of the 39-item Parkinson Disease Questionnaire = A 39 tételes Parkinson-kór-kérdőív török nyelvű változatának megbízhatósága és validitása

Background and purpose – This study aims to investigate the validity and reliability of the Turkish Version of the 39-item Parkin- son Disease Questionnaire. Methods – A total of 100 patients with Par- kinson’s disease who were admitted to the outpatient neurology clinic in Koc University and Istanbul University were enrolled. 39- item Parkinson Disease Questionnaire, Par- kinson Disease Quality of Life Questionnaire, Unified Parkinson’s Disease Rating Scale, Hoehn-Yahr Scale, and Short Form Health Survey-36 were administered to all partici- pants. 39-item Parkinson Disease Question- naire was repeated 2 weeks later. Results – The internal consistency coeffi- cient of the 39-item Parkinson Disease Ques- tionnaire was 0.957. Test-retest correlation ranged between r = 0.693-0.979. Reliability of Turkish version of the 39-item Parkinson Disease Questionnaire was found to be very high with the exclusion of one item (30th item). The scale was found to be consistent over time and correlated positively with Hoehn-Yahr Scale, and negatively with Unified Parkinson’s Disease Rating Scale, Par- kinson Disease Quality of Life Questionnaire, and Short Form Health Survey-36. Conclusion – Turkish version of the 39-item Parkinson Disease Questionnaire, with the exclusion of the 30th item can be used reli- ably in assessing the quality of life of Parkin- son’s patients. | Háttér és cél – A tanulmány célja a 39 téte- les Parkinson-kór-kérdőív török nyelvű vál- tozata megbízhatóságának és validitásának elemzése volt. Módszerek – Összesen 100 Parkinson-kó- ros beteget vontunk be, akiket a Koc Egye- tem és az Isztambuli Egyetem neurológiai ambulanciájára vettek fel. Minden résztvevő kitöltötte a 39 tételes Parkinson-kór kérdő- ívet, a Parkinson-kór életminőségi kérdőívet, az Egyesített Parkinson-kór pontozó skálát, a Hoehn–Yahr-skálát és a 36 tételes Egész- ségfelmérés rövid formáját. A 39 tételes Par- kinson-kór kérdőív kitöltését 2 héttel később megismételték. Eredmények – A 39 tételes Parkinson- kór kérdőív belső konzisztencia-együtt- hatója 0,957 volt. A teszt-reteszt korreláció r = 0,693 és 0,979 között mozgott. A 39 té- teles Parkinson-kór kérdőív török nyelvű változatának megbízhatósága nagyon magasnak bizonyult, egy tétel (a 30. tétel) kivételével. A skála időben konzisztensnek bi- zonyult, és pozitívan korrelált a Hoehn–Yahr- skálával, míg negatívan korrelált az Egyesített Parkinson-kór pontozóskálával, a Parkinson- kór életminőségi kérdőívvel és a 36 tételes Egészségfelmérés rövid formájával. Következtetés – A 39 tételes Parkinson-kór kérdőív török változata a 30. tétel kizárásával megbízhatóan használható a Parkinson-kó- ros betegek életminőségének felmérésére

A novel shoulder disability staging system for scapulothoracic arthrodesis in patients with facioscapulohumeral dystrophy

Background: Scapulothoracic arthrodesis (STA) is a well-established surgical technique to provide scapular stabilisation in patients with facioscapulohumeral dystrophy (FSHD). There is no staging or scoring systems available to guide surgical decision. The aim of this study was to develop a staging system to evaluate the shoulder disability in patients with FSHD to guide surgical decision-making and assess its reliability among surgeons

The prognostic role of thyroid transcription factor-1 in lung adenocarcinoma

Aims: In this study, we investigated the expression of thyroid transcription factor-1 (TTF-1) in lung adenocarcinoma patients' samples and analyzed the association of TTF-1 with clinicopathological parameters, prognosis, and treatment options in patients with lung adenocarcinoma. Subjects and Methods: This retrospective study enrolled 200 patients who were histologically confirmed lung adenocarcinoma with Stage I-IV disease, between 2008 and 2015 years. The cytological archive of these hospitals' Pathology Department was searched. The available slides and the clinical information were reviewed and correlated. All analyses were conducted by SPSS version 15.0 statistical software. Results: Sixty-five (32.5%) of the patients showed TTF-1 negativity and 135 (67.5%) of them showed TTF-1 positivity. The median survival for TTF-1 positive and negative patients was 19.6 and 12.2 months, respectively. We did not find any statistical significance in-between the parameters in terms of the survival data. In TTF-1-negative group, the survival time of epidermal growth factor receptor mutation positive (P = 0.049), cytokeratin 7 (CK7) positive (P = 0.009) patients and those who had received curative radiotherapy (P = 0.028) was significantly better as compared to TTF-1-positive group. We also analyzed the relation between TTF-1 and survival outcome or chemotherapy selection in Stage IV disease. We could not identify any correlation between TTF-1 and survival outcome or treatment selection. Conclusions: This study suggests that TTF-1 is not a favorable prognostic factor in lung adenocarcinoma patients. The prognostic role of CK7 and relationship between TFF-1 expression in lung adenocarcinoma and predictive role of TTF-1 expression for the selection of first-line treatment in Stage IV lung adenocarcinoma should be validated in prospective and randomized studies